Missouri Long-Term Care Information Update

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/23 through 3/31/23 is due May 15, 2023.

Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

CMS PBJ webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ
PBJ Reference Manuals – https://qtso.cms.gov/vendors/payroll-based-journal-pbj-vendors/reference-manuals
PBJ Training – https://qtso.cms.gov/training-materials/payroll-based-journal-pbj

On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) will transition to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and reports. As part of this transition, the QIES Assessment Submission And Processing (ASAP) system for MDS submissions will be turned off on Thursday, April 13 at 8:00 p.m. ET. Providers should submit completed MDS records prior to 8:00 p.m. ET on April 13 to the QIES ASAP system or wait until 8:00 a.m. ET on Monday, April 17 to submit data in iQIES. Once the transition is complete, all new, modification, or inactivation records must be submitted in iQIES, even if the original record to be corrected was accepted into the QIES ASAP system. Providers are expected to take into account all submission requirements when determining the date that they submit completed MDS records, including but not limited to, submission timeliness, claims processing, and care planning requirements.

MDS submission and records will be available in iQIES beginning Monday, April 17, 2023 at 8:00 a.m. ET. iQIES will be the only system in which MDS data submissions can occur.

What to Expect with the Minimum Data Set (MDS) Transition to iQIES

Please note there are some system-generated reports in the CASPER application that will not be migrated over to the iQIES folders. Users should download and save or print any of these system-generated reports that they wish to retain. For more information on MDS reports, please visit: https://qtso.cms.gov/news-and-updates/what-expect-minimum-data-set-mds-transition-iqies-april-17-2023.

Register for an iQIES Account

Please note that failure to obtain access to iQIES prior to April 17, 2023 will impact your ability to submit MDS records once the migration is complete. For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account.

iQIES Service Center

If you have questions or require assistance, please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or send an email. Please note that call volume may be higher than normal during this time.

On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) will transition to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and reports. As part of this transition, the QIES Assessment Submission And Processing (ASAP) system for MDS submissions will be turned off on Thursday, April 13 at 8:00 p.m. ET. Providers should submit completed MDS records prior to 8:00 p.m. ET on April 13 to the QIES ASAP system or wait until 8:00 a.m. ET on April 17 to submit data in iQIES. Once the transition is complete, all new, modification, or inactivation records must be submitted in iQIES, even if the original record to be corrected was accepted into the QIES ASAP system. Providers are expected to take into account all submission requirements when determining the date that they submit completed MDS records, including but not limited to, submission timeliness, claims processing, and care planning requirements.

Register for an iQIES Account

Please note that failure to obtain access to iQIES prior to April 17, 2023 will impact your ability to submit MDS records once the migration is complete. For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account

Outlined below are a few highlights and expectations for the release of the iQIES MDS submission and reporting functionality.

Key Highlights of iQIES

• Users will be able to securely access iQIES at any time, from any location (provided there is an internet connection).
• Users will log in once to iQIES. No longer will users be required to log into CMSNet and then into separate applications to upload MDS records or access reports.
• Users will have access to tips and information to guide them throughout the MDS submission process and accessing reports.
• Users will be allowed to upload MDS assessments in a similar manner as was done in the QIES.
• MDS reports will be similar to those in the Certification and Survey Provider Enhanced Reporting (CASPER) application, with some new functionality built in.
  • Users can initially view the report information on the screen and if desired, can then download the report to a Portable Document Format (PDF) or Comma-Separated Values (CSV) file.
  • Users can schedule reports to run at their desired interval and frequency.

What to Expect for Providers and Vendors

• QIES Assessment Submission And Processing (ASAP) system for MDS submissions will be turned off as of Thursday, April 13 at 8:00 p.m. ET.
• Beginning April 17, 2023 MDS records will be available in iQIES. iQIES will be the only system in which MDS data submissions can occur. 

Report Information – QIES/CASPER

• The reports in the following report categories in CASPER will become permanently unavailable on Thursday, April 13, 2023 at 8:00 p.m. ET:
  • MDS 3.0 NH Final Validation Report
  • MDS 3.0 SB Final Validation Report
  • MDS 3.0 Submitter Validation Report
  • MDS 3.0 NH Provider
    • Exception for this report category: the MDS 0003D/0004D Package Reports in this category will remain available
  • MDS 3.0 SB Provider
  • MDS 3.0 QM Reports
  • SNF Quality Reporting Program

• The ASAP system-generated Nursing Home (NH) and Swing Bed (SB) final validation reports in the facility-specific Validation Report (VR) folders will reflect processing information for MDS records submitted to the ASAP system prior to the migration. These reports will not be migrated to the iQIES folder; however, users will be able to generate a new user-requested report in iQIES.
  • Note: since the QIES system-generated final validation reports will not be moved into iQIES, users should download and save or print any system-generated reports that they wish to retain.
• Users will continue to access reports or files in their provider’s shared non-validation report folder in CASPER until summer 2023 when delivery of the SNF VBP files and provider preview reports will be migrated into iQIES.
  • The shared non-validation report folders are named in this manner:
    • [State Code] LTC [Facility ID] for nursing home providers
    • [State Code] SB [Swing Bed ID] for swing bed providers
  • The reports/files in these folders could include those listed below.
    • SNF QRP Provider Preview Reports
      • April 2023 reports will be in CASPER
    • MDS 3.0 Provider-Level Quality Measure and MDS 3.0 Resident-Level Quality Measure Provider Preview reports
      • April 2023 reports will be in CASPER
    • SNF VBP files
    • Non-compliance Notification Letters, if applicable

• Note: since the files listed above will not be moved into iQIES, users should download and save or print any of the reports or files that they wish to retain.

Report Information – iQIES

Following completion of the migration, users will be allowed to access and run the user-requested reports in iQIES. User’s access to the reports below will be similar to the access in the CASPER Reporting application, so long as your new HARP role allows access to generate and view reports. Users will only be allowed to run reports for the providers to which they have access.

Below are the report categories/types and each MDS report that is associated to the category/type combination.

• Provider Report Category / Validation Report Type
  • MDS 3.0 NH Final Validation Report
  • MDS 3.0 SB Final Validation
  • MDS 3.0 Submitter Final Validation

• Provider Report Category / Submission Report Type
  • MDS 3.0 Activity
  • MDS 3.0 Missing OBRA Assessment

• Provider Report Category / Error Report Type
  • MDS 3.0 NH Error Detail
  • MDS 3.0 SB Error Detail

• Provider Report Category / Admission/Discharge Report Type
  • MDS 3.0 Admissions/Reentry – Discharges Report

• Provider Report Category / Roster Report Type
  • MDS 3.0 Roster

• Quality Measure Report Category / Facility-Level Quality Measure
  • MDS 3.0 Facility Characteristics Report
  • MDS 3.0 Facility-Level QM Report
  • SNF Quality Reporting Program (QRP) Facility-Level QM Report

• Quality Measure Report Category / Resident/Patient-Level Quality Measure
  • MDS 3.0 Resident-Level QM Report
  • SNF QRP Resident-Level QM Report

• Quality Measure Report Category / Review and Correct
  • SNF QRP Review & Correct Report

• Quality Measure Report Category / Provider Threshold Report
  • SNF QRP Provider Threshold Report

• MDS 3.0 QM Package Reports / Package Reports
  • MDS 3.0 QM Package Reports

• System-generated MDS 3.0 NH and SB Final Validation Reports for MDS records submitted to iQIES will be accessed in the MDS 3.0 Final Validation Reports permanent folder in iQIES.

Data Availability for iQIES User-Requested Reports

• Data for the Provider reports above will be available for Calendar Year (CY) 2013 (01/01/2013-12/31/2013) forward.
• Data for the Quality Measure reports above will be available for Fiscal Year (FY) 2022 (10/01/2021-09/30/2022) forward.
  • Users wishing to retain Quality Measure reports for older time periods should obtain those reports from CASPER prior to the migration.

Resident Internal IDs on MDS and SNF QRP Reports

• As part of the MDS submission and reporting transition, MDS 3.0 records that had previously been processed and accepted into the QIES ASAP system will be migrated into iQIES. As part of this migration, a new unique state-level patient identifier has been created and will replace the previous QIES ASAP system-assigned Resident Internal ID on all MDS assessment records.
• This new state-level patient ID will display on any MDS or SNF QRP report(s) that currently display the Resident Internal ID value.
• For example, a resident whose Resident Internal ID was initially 58608036 as assigned from QIES ASAP, will now be 298899278 as assigned by iQIES for all reporting and processing purposes.

SNF QRP Quality Measure Report Information

• The SNF QRP quality measures in iQIES will be calculated using the quality measure specifications and supportive documentation that were in effect 10/01/2022, including the following:
  • SNF-Quality-Measure-Calculations-and-Reporting-User’s-Manual-V4.0
  • Risk-Adjustment-Appendix-File-for-SNF-Effective-10-1-2022
  • SNF-Mobility-Model-ICD10-HCC-Crosswalk-Effective-10-01-2022
  • SNF-Self-Care-Model-ICD10-HCC-Crosswalk-Effective-10-01-2022

The above files can be downloaded from the SNF QRP Measures and Technical Information page on the CMS website: https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/nursinghomequalityinits/skilled-nursing-facility-quality-reporting-program/snf-quality-reporting-program-measures-and-technical-information.

• The SNF QRP Facility-Level QM report will contain updated Medicare Fee-For-Service claims measure results when a Quarter End Date of 03/31/2022 or later is selected when requesting the report.
• The new SNF Healthcare Personnel (HCP) Influenza vaccination measure will display on the iQIES SNF Provider Threshold Report following the migration; however, submission success results for this measure will not display on the report until the data submission deadline date for Q4, 2022 (12/31/2022) has passed.
  • The data submission deadline date for Q4, 2022 is May 15, 2023.

iQIES Service Center

If you have questions or require assistance, please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or send an email. Please note that call volume may be higher than normal during this time.

The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.18.11 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.18.11 will be effective beginning October 01, 2023.

This version of the MDS 3.0 RAI Manual contains substantial revisions related to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which requires that standardized assessment items be collected across post-acute care (PAC) settings. Standardized data will enable cross-setting data collection, outcome comparison, exchangeability of data, and comparison of quality within and across PAC settings. Additionally, the language of the manual has been updated throughout to be gender neutral. Guidance and examples in numerous chapters and appendices have been revised for clarification and to reflect current regulations and best practices. Due to the scope of the revisions, CMS will not issue Replacement Pages for v1.18.11; those wishing to continue using a physical copy of the manual are encouraged to print the new version.

The final Minimum Data Set (MDS) 3.0 Item Sets version v1.18.11 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.18.11 will be effective beginning October 01, 2023.